How To Use CPT Code 20932
CPT code 20932 describes the placement of an allograft, including templating, cutting, placement, and internal fixation, when performed osteoarticular, including articular surface and contiguous bone. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.
1. What is CPT Code 20932?
CPT 20932 can be used to describe the placement of an allograft, which is a tissue graft harvested from one person for another, involving both bone and joint structures. This code is used when the provider performs templating, cutting, placement, and internal fixation of the allograft, specifically in cases where the procedure is performed on osteoarticular structures, including the articular surface and contiguous bone.
2. Official Description
The official description of CPT code 20932 is: ‘Allograft, includes templating, cutting, placement and internal fixation, when performed osteoarticular, including articular surface and contiguous bone (List separately in addition to code for primary procedure).’ It is important to note that CPT code 20932 should not be reported in conjunction with certain other codes, such as 20933, 20934, 23200, 24152, 27078, 27090, 27091, 27448, 27646, 27647, and 27648.
3. Procedure
The procedure for CPT code 20932 involves the placement of an allograft in a patient’s osteoarticular structures, including the articular surface and contiguous bone. The provider begins by examining the area where a large bone tumor was previously excised and where the allograft will be placed. They may need to incise and release tendons and capsular tissues to position the joint and bones for grafting. The provider then performs an osteotomy, which is an incision into the bone, at the appropriate location determined by preoperative radiographs.
After removing any remaining soft tissues and excised bone from the field, the allograft, which has been prepared by an assistant, is cut and shaped to fit the template previously created. The allograft is inspected to ensure its health and tailored to fit the defect caused by the tumor excision. The provider then reconstructs the joint by suturing the patient’s tendons to the allograft tendons and repairing the joint capsule. The cortical bone of the allograft is fitted to the osteotomy site and stabilized using compression plates and internal fixation if necessary. The wound is lavaged with sterile saline, deep tissues are repaired in layers, and the skin is closed with sutures. A cast or brace may be applied to immobilize the joint for stabilization until union is confirmed by X-rays.
4. Qualifying circumstances
CPT code 20932 is used for patients who require the placement of an allograft in their osteoarticular structures, including the articular surface and contiguous bone. This procedure is typically performed when a large bone tumor has been excised, and the defect needs to be filled. The allograft can be harvested from cadavers or living individuals related or unrelated to the recipient. It is important to note that CPT code 20932 should not be reported with certain other codes, as mentioned in the official description.
5. When to use CPT code 20932
CPT code 20932 should be used when the provider performs the placement of an allograft in the patient’s osteoarticular structures, including the articular surface and contiguous bone. This code should be reported in addition to the primary procedure code that describes the main surgical intervention. It is important to review the documentation and ensure that the procedure meets the specific criteria outlined in the code description.
6. Documentation requirements
To support a claim for CPT code 20932, the provider must document the following information:
- Patient’s diagnosis and the need for allograft placement
- Details of the templating, cutting, placement, and internal fixation procedures
- Specific osteoarticular structures involved
- Date of the procedure
- Start and end time of the procedure
- Any additional procedures performed in conjunction with the allograft placement
- Any complications or unexpected findings
- Signature of the provider
7. Billing guidelines
When billing for CPT code 20932, ensure that the procedure meets the specific criteria outlined in the code description. It is important to review the documentation and accurately report the primary procedure code in addition to CPT code 20932. Additionally, do not report CPT code 20932 in conjunction with the specified other codes. Familiarize yourself with the payer’s guidelines and any specific requirements they may have for reporting this code.
8. Historical information
CPT code 20932 was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.
9. Similar codes to CPT 20932
Five similar codes to CPT 20932 include:
- CPT 20933: Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary structural (ie, involving the shafts of long bones)
- CPT 20934: Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary nonstructural (ie, not involving the shafts of long bones)
- CPT 23200: Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)
- CPT 24152: Excision or curettage of bone cyst or benign tumor, tibia or fibula, with allograft
- CPT 27078: Injection procedure for hip arthrography or anesthetic agent, including arthrocentesis
9. Examples
- A patient undergoes excision of a large bone tumor involving joint cartilage and adjacent bone. The provider performs templating, cutting, placement, and internal fixation of an allograft to fill the defect.
- A patient requires the placement of an allograft in their knee joint after the excision of a bone tumor. The provider performs the necessary procedures to prepare and fixate the allograft in the osteoarticular structures.
